Idea Transcript
RUG-IV Cheat Sheet Includes calculations to determine resident late loss ADL Score. For specific info on RUG-IV, please refer to Chapter 6 in the LTC RAI User's Manual Version 3.0.
Category I - Rehabilitation Plus Extensive Services ADL = 2 — 16
RUG-IV
ADL Score
See Rehab Criteria (Category II) and Extensive Services Criteria (Category III) Rehabilitation Ultra High PLUS Extensive Service(s) Rehabilitation Very High PLUS Extensive Service(s) Rehabilitation High PLUS Extensive Service(s) Rehabilitation Medium PLUS Extensive Service(s) Rehabilitation Low PLUS Extensive Service(s)
RUX RUL RVX RVL RHX RHL RMX RML RLX
11 — 16 2 — 10 11 — 16 2 — 10 11 — 16 2 — 10 11 — 16 2 — 10 2 — 16
RUG-IV
ADL Score
RUC RUB RUA
11 — 16 6 — 10 0—5
Category II - Rehabilitation ADL = 0 — 16 Ultra High Criteria 720 minutes or more (total) of therapy per week 1 Discipline for at least 5 days A second discipline for at least 3 days 144 minutes or more if MSSAI = YES Very High Criteria 500 minutes or more (total) of therapy per week At least 1 discipline for at least 5 days 100 to 143 minutes if MSSAI = YES High Criteria 325 minutes or more (total) of therapy per week At least 1 discipline for at least 5 days 65 to 99 minutes if MSSAI = YES Medium Criteria 150 minutes or more (total) of therapy per week At least 5 days of any combination of the 3 disciplines 30 to 64 minutes if MSSAI = YES Low Criteria 45 minutes or more (total) of therapy per week At least 3 days of any combination of 3 disciplines 4 2 or more Restorative Nursing Services received, each for 6 or more days for at least 15 minutes. 15 to 29 minutes if MSSAI = YES
AND AND
AND
AND
AND
AND AND
RVC RVB RVA
11 — 16 6 — 10 0—5
RHC RHB RHA
11 — 16 6 — 10 0—5
RMC RMB RMA
11 — 16 6 — 10 0—5
RLB RLA
11 — 16 0 — 10
ADL = 2 — 16
RUG-IV ES3 ES2 ES1 B
Tracheostomy care AND Ventilator or Respirator (while a resident) Tracheostomy care OR Ventilator or Respirator (while a resident) Infection Isolation (while a resident)
Category IV - Special Care High ADL = 2 — 16
1. Tube Feeding Classification Requirement K0700A is 51% or more of total calories OR K0700A is 26% to 50% of total calories AND K0700B is 501 cc or more per day fluids enteral intake in the last 7 days 2. Selected Ulcer Treatments • Pressure relieving chair/bed++ • Turning/Repositioning • Nutrition or hydration intervention • Ulcer Care • Application of Dressing (Not to feet) • Application of Ointment (Not to feet) ++ Count as one service if both are provided 3. Selected Skin Treatments • Surgical Wound Care • Application of Dressing (Not to feet) • Application of Ointment (Not to feet)
RUG-IV ADL Score HE2 HE1 HD2 HD1 HC2 HC1 HB2 HB1
RUG-IV
• Cerebral palsy with ADL score ≥ 5 • Multiple sclerosis with ADL score ≥ 5 • Parkinson’s disease with ADL score ≥ 5 • Respiratory failure and oxygen therapy while a resident 1 • Feeding tube • 2 or more stage 2 pressure ulcers with 2 or more 2 selected skin treatments • Any stage 3 or 4 pressure ulcer with two or more 2 selected ulcer treatments • 2 or more venous/arterial ulcers with two or more 2 selected ulcer treatments • 1 stage 2 pressure ulcer and 1 venous/arterial ulcer 2 with 2 or more selected ulcer treatments • Foot infection, diabetic foot ulcer or other open lesion of foot with application of dressings to the feet • Radiation treatment while a resident • Dialysis treatment while a resident Signs of depression used for end splits: PHQ score ≥10
15-16 15-16 11-14 11-14 6-10 6-10 2-5 2-5
End Splits Depression No Depression Depression No Depression Depression No Depression Depression No Depression
ADL = 0 — 16
4. Restorative Nursing Services
End Splits
15—16 15—16
Depression No Depression
LD2 LD1
11—14 11—14
Depression No Depression
LC2 LC1
6 —10 6 —10
Depression No Depression
LB2 LB1
2—5 2—5
Depression No Depression
RUG-IV
• Residents with Extensive Services, Special Care High or Special Care Low • Pneumonia • Hemiplegia and ADL score ≥ 5 • Surgical wounds or open lesions with 3 treatment • Burns • Chemotherapy while a resident • Oxygen while a resident • IV medications while a resident • Transfusions while a resident Signs of depression used for end splits: PHQ score ≥10
ADL Score
CE2 CE1 CD2 CD1 CC2 CC1 CB2 CB1 CA2 CA1
End Splits
15 — 16 15 — 16 11 — 14 11 — 14 6 — 10 6 — 10 2—5 2—5 0—1 0—1
Depression No Depression Depression No Depression Depression No Depression Depression No Depression Depression No Depression
CATEGORY VII- Behavioral Symptoms and Cognitive Performance RUG-IV
• Residents has a cognitive impairment BIMS score ≤ 9 or CPS ≥ 3 • Hallucinations • Delusions • Residents displaying one of the following symptoms: •• Physical or verbal behavioral symptoms toward others •• Other behavioral symptoms •• Rejection of care •• Wandering 4 • Restorative Nursing Services used for end splits
ADL Score
BB2
2—5
BB1
2—5
BA2
0—1
BA1
0—1
End Splits ≥ 2 restorative nursing < 2 restorative nursing ≥ 2 Restorative nursing < 2 restorative nursing
CATEGORY VIII- Reduced Physical Function ADL = 0 — 16
RUG-IV
• Residents who do not meet the conditions in any of the previous categories • Behavioral Symptom & Cognitive Performance with RUG-IV ADL score > 5 • Restorative Nursing Services used for end splits 4
Signs of depression used as end splits: PHQ score ≥10
• Urinary toileting program and/or bowel toileting program ++ • Passive and/or active ROM ++ • Splint or brace assistance • Bed mobility and/or walking training++ • Transfer training • Dressing and/or grooming training • Eating and/or swallowing training • Amputation/prostheses care • Communication training ++ Count as one service even if both provided
ADL Score
LE2 LE1
CATEGORY VI- CLINICALLY COMPLEX
ADL = 0 — 5
Category III - Extensive Services
• Comatose and completely ADL dependent or ADL did not occur • Septicemia •Diabetes with both Insulin injections for all 7 days and insulin order changes on 2 or more days • Quadriplegia and ADL score >= 5 • Chronic obstructive pulmonary disease (COPD) and shortness of breath when lying flat • Fever with one of the following: Pneumonia, Vomiting, Weight loss or Feeding tube1 • Parenteral/IV feedings • Respiratory therapy for 7 days
Category V — Special Care Low ADL = 2 — 16
ADL Score
PE2 PE1 PD2 PD1 PC2 PC1 PB2 PB1 PA2 PA1
End Splits
15 — 16 15 — 16 11 — 14 11 — 14 6 — 10 6 — 10 2—5 2—5 0—1 0—1
≥ 2 restorative < 2 restorative ≥ 2 restorative < 2 restorative ≥ 2 restorative < 2 restorative ≥ 2 restorative < 2 restorative ≥ 2 restorative < 2 restorative
RUG-IV Late Loss ADL Calculations (Enter ADL score for each item below) G0110 (1) G0110 (2) Self Performance Staff Support Bed Mobility, Toilet and Transfer Use -, 0, 1, 7, or 8 AND 2 AND 3 AND 4 AND 3 or 4 AND
any number any number -, 0, 1, or 2 -, 0, 1, or 2 3
Bed Mobility (G0110A) Transfer (G0110B)
ADL Score
= = = = =
= =
0 1 2 3 4
G0110 (1) Self Eating -, 0, 1, 2, 7 or 8 -, 0, 1, 2, 7 or 8 3 or 4 3 4
G0110 (2) Staff Support
AND -, 0, 1, 8 AND 2 or 3 AND -, 0 or 1 AND 2 or 3 AND 2 or 3
____ Toilet Use (G0110I) ____
Eating (G0110H)
Total RUG-IV ADL Score: Compliments of ADL Data Systems, Inc.
ADL Score
= = = = =
= =
0 2 2 3 4
______ ______